Managed Care Coordinator & Patient Advocate

Empower Healthcare Solutions; Little Rock (AR); On-site; USD 19,000 - 28,000; Full time

Job summary

Empower Healthcare Solutions LLC in Little Rock, AR is seeking an entry-level Care Coordinator to support coordinated care services. This role focuses on verifying eligibility, referrals, and authorizations while guiding members and coordinating with providers and insurers.

You will also educate members, address social determinants of health, verify coverage, and ensure compliant documentation in a collaborative team environment.

Qualifications

• High School diploma and One (1) year experience in the mental health field.
• Bachelor's degree in a relevant field such as healthcare, social work, Psychology or social services and other healthcare related field preferred
• Knowledge of managed care principles, processes, and regulations.
• Familiarity with health insurance terminology, coverage, and benefit structures.
• Strong organizational skills with the ability to manage multiple tasks simultaneously.
• Excellent communication and interpersonal skills to effectively collaborate with internal and external stakeholders.
• Detail-oriented and ability to maintain accurate records and documentation.

Responsibilities

• Oversee and facilitate the coordination of managed care services, including verifying eligibility, managing referrals, and obtaining authorizations for medical procedures, treatments, and services.
• Deliver personalized health education and coaching to members based on identified concerns outlined in treatment and service plan, requested services, ensuring compliance with established guidelines and policies.
• Provide member support access in addressing social determinants of health, such as facilitating access to exercise opportunities and nutritious food.
• Verify insurance coverage and benefits for patients, ensuring accurate and up-to-date information is obtained and documented.
• Conduct utilization reviews to evaluate the medical necessity and appropriateness of care.
• Collaborate with insurance companies and healthcare providers to ensure availability and quality of services.
• Facilitate coordination with diverse healthcare providers for diagnostics, ambulatory care, and hospital services.
• Serve as a point of contact for members, addressing questions, concerns, and complaints related to managed care services, and advocating for their needs within the organization.
• Encourage initiatives aimed at improving the health of patients and communities, including outreach and quality improvement initiatives.
• Coordinate community-based management of medication therapy.
• Identify opportunities for process improvement and efficiency enhancement in managed care operations.

Skills

Strong organizational skills

Excellent communication skills

Detail-oriented

Ability to manage multiple tasks

Education

Two year degree

Tools

Healthcare IT systems

Job description

Empower Healthcare Solutions LLC in Little Rock, AR is seeking an entry-level Care Coordinator to support coordinated care services. This role focuses on verifying eligibility, referrals, and authorizations while guiding members and coordinating with providers and insurers.

You will also educate members, address social determinants of health, verify coverage, and ensure compliant documentation in a collaborative team environment.